Risk Pool Name / Acronym
Minnesota Comprehensive Health Association / MCHA
Insurance Regulation Establishing Risk Pool
Chapter 317, Revised in 2005 under ;Chapter 62E
To be eligible for the coverage, individuals must have exhausted their COBRA benefits; individuals must be working for employers who do not offer health insurance; individuals must have exceeded lifetime maximum limits, or their previous coverage and former employees of bankrupt companies.
MCHA offers seven different individual health plans. Five of the plans are PPO plans with varying deductible amounts. The other two plans are High Deductible Health Plan and Basic Medicare Supplement Plan.
The five PPO plans offering the same level of coverage with different deductible options of $500, $1,000, $2,000, $5,000 and $10,000. Once the plan deductible has been met, you pay a coinsurance of 20% for most covered medical benefits when using an in-network provider. Your maximum annual coinsurance limit is $3,000, except on the $5,000 and $10,000 deductible plan in which the deductible is your out-of-pocket maximum.
The High Deductible Health Plan meets federal requirements for Health Savings Accounts. Once you have met the annual deductible, you are covered at 100% for covered medical expenses.
The Medicare Supplemental plan is a Basic Medicare Supplemental plan in which MCHA will pay the 20% coinsurance for Medicare after you have met the Medicare deductibles.
Maximum Benefit Limits
MCHA PPO health plans offer a lifetime maximum benefit of $5,000,000.
MCHA is open to enrollment at all times. To be eligible under cover through federal HIPAA regulations, you must apply for coverage within 63 days of the termination date of your previous group health plan or COBRA expiration date.
MCHA premiums are based on your age, your gender, your MCHA plan selection and your history of tobacco use.
MCHA premiums are authorized by the insurance commission and must fall between 101% and 125% of the standard risk rate available to residents of Minnesota that are covered under individual health insurance of similar benefit levels.
For all MCHA policies, no benefits are payable during the first six months of coverage for expenses for any preexisting condition, injury, illness or other physical or mental condition that was diagnosed, treated or evaluated during the 90 days prior to the effective date of coverage. Some exceptions apply to the preexisting condition limitation. In order to determine if your eligibility for a waiver, you must request a waiver of the preexisting condition limitation by completing waiver request section of the MCHA application.
Minnesota Comprehensive Health Association
Customer Service, Mail Route CP555
401 Carlson Parkway
Minnetonka, MN 55305-5387
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